目的
介绍 3-D 打印技术辅助人工全髋关节置换术（total hip arthroplasty，THA）治疗 1 例 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形的临床经验。
方法
2017 年 2 月，收治 1 例 40 岁 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形的女性患者。术前采用 Mimics 软件建立患侧髋关节三维数字模型，3-D 打印患侧股骨模型，根据模型设计股骨假体截骨位置及截骨大小。采用 Magics 19.0 软件设计制作个性化股骨截骨导板三维模型，并 3-D 打印。THA 术中应用截骨导板进行股骨截骨矫形。
结果
手术时间 98 min。术后第 2 天髋关节正侧位 X 线片检查示，髋臼假体安放、螺钉植入角度及位置均理想，恢复髋臼正常旋转中心，股骨截骨两端对位良好，下肢力线恢复正常。患者获随访 6 个月，Harris 评分为 95 分，较术前（38 分）明显提高；疼痛视觉模拟评分（VAS）为 0 分，较术前（7 分）明显下降。随访期间未发生假体松动、感染、血栓形成等并发症。
结论
3-D 打印技术辅助 THA 治疗 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形，能简化手术操作、提高手术准确度、减少组织损伤、降低手术风险，取得满意临床疗效。
Citation：
王百盛, 张敬东, 韩文锋, 刘欣伟, 王宁, 刘海立, 李如珍. 3-D 打印技术辅助人工全髋关节置换术治疗 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形一例
. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(1): 125-127. doi: 10.7507/1002-1892.201705015
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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- 1. Rakow A, Simon P, Perka C. Hip arthroplasty in the presence of proximal femoral deformity. Orthopade, 2015, 44(7): 510-522.
- 2. 彭建平, 王旭义, 朱俊峰, 等. 发育性髋关节发育不良患者股骨近端畸形特点的研究. 中华关节外科杂志 (电子版), 2017, 11(3): 228-233.
- 3. Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1): 15-23.
- 4. Sen C, Bilsel K, Elmadag M, et al. Acetabuloplasty at the anatomic centre for treating Crowe class Ⅲ and Ⅳ developmental hip dysplasia: a case series. Hip Int, 2016, 26(4): 360-366.
- 5. Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type IV developmental dysplasia. J Arthroplasty, 2012, 27(9): 1629-1635.
- 6. Li L, Yu M, Yang C, et al. Total hip arthroplasty (S-ROM stem) and subtrochanteric osteotomy for Crowe type Ⅳ developmental dysplasia of the hip. Indian J Orthop, 2016, 50(2): 195-200.
- 7. Greber EM, Pelt CE, Gililland JM, et al. Challenges in total hip arthroplasty in the setting of developmental dysplasia of the hip.J Arthroplasty, 2017, 32(9S): S38-S44.
- 8. Papagelopoulos PJ, Trousdale RT, Lewallen DG. Total hip arthroplasty with femoral osteotomy for proximal femoral deformity. Clin Orthop Relat Res, 1996, (332): 151-162.
